Rave Hearty
Finally the weekend has come. You get ready to let out all the tension accumulated because of your stressful job. You dress all black and tight. The party tonight will have your favourite underground music coming out of the big and loud speakers.
You get to the entrance at midnight and meet your friends. I see you while I am relaxing inside the ambulance. Me and my colleagues have to stay here since there’s always someone getting sick in this place for some reason. Once you are inside you start dancing and drinking. The bass frequencies are so intense that make your fragile heart skip and even go into fibrillation for a few seconds. You are so happy and excited that decide to go literally in front of the big speakers with your friends. The loud sounds overwhelm you.
The DJ changes the song and turns up the volume even more. The rhythm becomes so heavy that you can feel like someone is throwing precordial thumps at you “TUM, TUM, TUM…”. Your very fragile heart can’t take It anymore and you fall on the ground. Your friends immediately pick you up and bring you to my ambulance. I watch your lifeless body from far away while It’s coming towards me and I get ready by turning on all the machines. I open the ambulance rear doors, get inside and as soon as your friends reach me my colleague Lana helps me putting you on the stretcher.
“She fainted!” they shout in despair. “Did she drink a lot?” I ask them while me and Lana check your pulse with our stethoscopes. They say you were pretty drunk before fainting. But It doesn’t take too much before me and my colleague understand that you are in v-fib. “Lana! Charge the defibrillator now!”. I take the scissors and cut your black tight t-shirt. You breast and sternum are now exposed. I move down to unbutton the pants and bring them down just enough so the femoral artery is free from their grasp. Meanwhile Lana puts on you two ekg lead between your neck and your shoulder. The other one on the low-left part of your belly. The monitor turns on and confirms our thoughts. All the alarms pop up and many loud beeps can be heard. “We are losing her doctor!” Lana turns the defibrillator knob on the 150j position. A loud raising sound starts. She hands me the two big black paddles and I face those towards her so she can apply the conductive gel. I rub the paddles against each other and the raising sound is replaced by an intermittent beeping. Shock is ready to be delivered. I place the first paddle on your right breast and the second one right under your left one. “CLEAR!” I shout and press the red buttons. The electricity goes through your body that rises up and stays in that tension state for two seconds before hitting the stretcher with your back again. “No change doctor. Hit her again!” Lana screams at me as the monitor still shows v-fib. So she turns the knob to 250j. The raising sound starts again. I am already in position with the paddles and I am ready to press the buttons. Meanwhile I notice some goosebumps all over your sternum and your nipples getting hard because of the cold iron paddles. The defibrillator is charged so I press the buttons. “CLEAR!” I shout again. Your back arches violently. Your navel becomes oval. Your ribs and your hip bones press against your skin making them evident. Your muscles are all in tension. Your body stays in this state for at least 3 seconds and then comes back down. I watch the monitor and Lana: “Flatline, start cpr!” I say to her.
I remove the paddles from your body. The gel residue makes your breast and sternum shiny. As Lana places her hands between your breast she struggles a bit to keep those in place without slipping. She makes your stopped heart pumping again with her powerful and deep compressions while counting loud: “ONE, TWO, THREE, FOUR, FIVE, SIX, SEVEN…” Everytime she presses the sternum, your shoulders collapse towards your body. “… EIGHT, NINE, TEN, ELEVEN, TWELVE, THIRTEEN, FOURTEEN, FIFTEEN!”. I stare at both of you and her with the wet paddles in my hands ready to be used. Lana goes with another cycle of cpr: “ONE, TWO, THREE, FOUR, FIVE, SIX, SEVEN, EIGHT, NINE, TEN, ELEVEN, TWELVE, THIRTEEN, FOURTEEN, FIFTEEN!” ... “Doctor She is not responding!” She says to me after a few cycles. “She needs to be intubated!”
I place the paddles back inside the defibrillator and take the laryngoscope. I tilt your head back and insert It in your mouth. I look for the epiglottis and once I find It I raise It with the blade. Lana hands me the endotracheal tube so I insert very deep until Its tip is beyond the vocal cords. I remove the laryngoscope and while keeping the tube in place I mount the ambubag in It and leave It to Lana. I take a stethoscope and tell Lana to start bagging so I can check if the tube is in the airway. I start stething your lungs and I can actually hear breathing sounds as she pumps air so It has been inserted correctly. Now I start a few cycles of cpr: “ONE, TWO, THREE, FOUR, FIVE, SIX, SEVEN, EIGHT, NINE, TEN, ELEVEN, TWELVE, THIRTEEN, FOURTEEN, FIFTEEN!” “Breathe”… “Come back to me, come on!” … “ONE, TWO, THREE, FOUR, FIVE, SIX, SEVEN, EIGHT, NINE, TEN, ELEVEN, TWELVE, THIRTEEN, FOURTEEN, FIFTEEN!” “BREATHE!” I count and scream out loud but no change is visible on the monitor. “We need to shock her again!” I say. I get the defibrillator ready again while Lana keeps bagging you. Put some gel and rub the paddles. “Charging 300!” I press the charging button as the raising sound starts. I place the cold irons on your sternum and get ready to discharge the electricity as soon as I can. The intermittent beep comes up… “CLEAR!” Lana removes the ambubag and I press the red buttons. Your back arches for 3 seconds then comes back. “No change doctor, hit her again!” She says as she puts the ambubag in the tube again. I turn the knob again “Charging 360!”. The raising sound is very long this time. My forehead is sweating. I really want you to come back! The paddles are placed on your body and moved up and down by your sternum because of Lana’s bagging. Your body is sweating so hard like you are really fighting for your life with us. Once the defibrillator is charged I shout “CLEAR!” and Lana removes the ambubag. Your back arches violently like nothing before and stays in that tension state for at least 4 seconds. When you come back down It looks like nothing is changed but all of the sudden the monitor shows a pulse. So I immediately take my stethoscope to hear It.
The monitor beeps now are consistent and the peaks can be seen on the screen. Your heartbeat is intense and visible on your sternum and neck. You finally came back.
